Emergency
A big, restless dog retching with nothing coming up, his belly as tight as a football. A twisted stomach is operated on within hours, not days.
Emergency. A big dog with a swollen, tight belly who keeps retching and bringing nothing up? Leave now for the nearest 24-hour clinic with surgery and phone on the way. Do not give water, food or remedies, do not make him sick, do not walk him round to move the gas.
Call your own vet or the nearest clinic with an emergency service now, and set off. Do not ask a group what to do: every answer you wait for there is time lost for the dog.
Use this page to know what to observe, what to note and what to ask at the appointment, not to treat at home. If you still have doubts after a consultation, ask another vet or a specialist (dermatologist, internist) for a second opinion, not a group. And if you do not have a regular vet yet, find one now, while your dog is healthy: how to choose a veterinary clinic.
Your German Shepherd had his dinner at seven, wolfed down as usual. By nine he cannot settle. He lies down, gets up, turns round and looks at his belly. Then he tries to be sick: once, twice, five times, and nothing comes up except perhaps a little white froth. The belly behind his ribs looks fuller than normal and feels as tight as a football. If you are seeing this in a big dog, stop reading. Grab the keys, get in the car and ring the 24-hour clinic on the way. A twisted stomach kills within hours, and the only treatment is at the vet's, usually on the operating table. Read the rest of this page later, or have someone read it out in the car while you drive.
You are in the mountains, in the countryside or in a small town, and the nearest clinic with surgery is more than an hour away. Set off for it anyway and phone on the way. If a nearer practice answers, ask whether they can at least stabilise him and let the gas off, to buy time before surgery. Plenty of vets will do that and then send the dog on with a drip in place. The one thing you do not do is stay at home hoping it sorts itself out by morning.
| What you see | More likely | What to do |
|---|---|---|
| Retching with nothing coming up, tight belly getting bigger, restless, big dog | Gastric dilatation with a twisted stomach | Clinic with surgery, now |
| Ate a whole sack of kibble, big but soft belly, sleepy dog, bringing up food | Stomach overloaded with food | Phone the vet now; it can turn into a twist |
| Belly growing over days or weeks, not hours | Fluid in the abdomen, an enlarged organ, pregnancy | Appointment the same day or the next |
| Vomiting food, soft belly, bright dog | Upset stomach | Keep an eye on him and phone if it keeps happening |
The table is there so you do not waste time. The rule is still simple: in a big dog, a swollen belly plus retching means the clinic, even if it turns out in the end that he had simply eaten too much.
On the phone and when you arrive, give his breed and weight, when the signs started, when he last ate and how much, whether he brought anything up or only tried, whether he has bloated before, and whether a parent or littermate has had a twisted stomach. Here is what happens at the clinic, in order.
With surgery in time, most dogs recover and go on to live normally. The odds drop with every hour lost and with how much of the stomach has been damaged. Without surgery, GDV is almost always fatal. When the vet talks to you about odds and costs, ask them straight out what they saw on the X-ray and in the bloods. You are entitled to decide with all the facts in front of you.
Nobody knows for certain why GDV happens. The large studies have, though, found a handful of factors that keep turning up.
Large and giant breeds with a deep, narrow chest: the Great Dane (the most at risk), German Shepherd, Standard Poodle, setters, Weimaraner, Dobermann, St Bernard, Akita and their crosses. Risk rises with age and is higher in dogs with a first-degree relative (a parent or littermate) who has had a twist. Lean dogs and anxious, easily stressed dogs also show up more often in the figures.
For high-risk breeds, many surgical guidelines recommend it. It is the same stitch of the stomach to the body wall, done calmly in a healthy dog, usually at the same time as spaying or castration, sometimes by keyhole surgery with small incisions. The stomach can still fill with gas, but it can no longer twist, and the twist is the part that kills. Talk to your own vet about it while your dog is still a puppy.
Two or three meals a day instead of one big one. Slow him down with a slow-feeder bowl, a snuffle mat with the food scattered over it, or a stuffed toy. One large study found higher risk in dogs fed from a raised bowl, so in at-risk breeds keep the bowl on the floor unless your vet has a particular reason to raise it.
Many vets advise an hour's rest before and after the main meal, with no running and no rough play. The evidence here is weaker, but the advice costs you nothing. With working dogs, such as our mantrailing dogs, the big meal comes after training, once they have settled, never before a trail.
For anxious dogs, big changes (kennels, a house move, a long trip) are worth preparing for. On difficult days, a small meal and a quiet day help more than you might think.
Tell everyone at home, and whoever looks after the dog when you are away: retching with nothing coming up plus a swollen belly means the clinic, immediately. Save the 24-hour clinic's number in your phone today, not on the night you need it.
What dog owners search for most often on the internet about this problem, with the short answer. The answers are a guide only: the decision belongs to your dog's own vet, after an examination.
Repeated retching that brings up nothing, or only froth, a swollen, tight belly, especially behind the ribs, restlessness, heavy drooling, panting, looking round at his flank. Later come pale gums, laboured breathing, weakness and collapse. In a large, deep-chested dog, the first two signs together are enough to set off for the clinic.
Hours, not days. The twist cuts off the blood supply to the stomach and spleen, and shock sets in fast. There is no safe number of hours, but every hour of delay lowers the chance of survival. So you do not wait until morning or try anything at home: you go straight to a clinic that can operate.
Mainly large and giant breeds with a deep, narrow chest: the Great Dane, the most at risk, the German Shepherd, Standard Poodle, setters, Weimaraner, Dobermann, St Bernard, Akita and their crosses. Risk rises with age and is higher if a parent or littermate has had it. Small dogs get it very rarely, but not never.
The risk can be cut a great deal. In at-risk breeds, a preventive gastropexy, stitching the stomach to the body wall, usually done at the same time as neutering, stops the twist. Two or three meals a day instead of one, slow eating, the bowl on the floor and calm around meals also help. Talk to your own vet about gastropexy while your dog is still young.
In simple bloat (gastric dilatation) the stomach fills with gas and swells but stays in its normal position, and the vet can often relieve it without surgery. In GDV it also rotates on itself and needs emergency surgery. You cannot tell them apart at home, and both need the clinic straight away.
The information on this page is educational and does not replace an examination. For full details and a diagnosis, consult your dog's own veterinarian.
They often come together: the same causes, plans that complement each other.
Half a bar of dark chocolate missing, the grape stalk bare, the sock gone. Gather the wrapper, work out how much he ate and call. Do not make him sick yourself.
White foam on the floor, yellow bile on an empty stomach, or four bouts overnight and a chin on the floor. Not equally serious, and none is treated from the cupboard.
The bowl is empty in five seconds and sometimes the kibble comes back up. There is a reason for the speed, and you can slow meals down without taking food away.
The smell on the sofa, the tummy gurgling at night. Usually it's food and eating too fast. A swollen, tight belly in a large dog is a different thing: an emergency.
Call your own vet or the nearest clinic with an emergency service, say what happened and when, and set off. A call made from the car saves minutes on arrival.